Arlington, Virginia
Healthcare Reimbursement Analyst I - Patient Account - Credi... Job Opening in Arlington, Virginia - Healthcare Reimbursement Analyst I - (Patient Account - Credits and Refunds)
Under the supervision of the Senior Healthcare Analyst, provides reimbursement analysis for the purpose of reducing rejections, improving overall revenue and cash performance with managed care payers. Optimize payer reimbursement and efficient A/R management.
Essential Duties and Responsibilities:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.
1. Reviews refund/overpayment requests from insurance payers and other MFA employees to determine if requests are applicable.
2. Posts debits for approved refunds.
3. Responsible for returned checks and reporting as unclaimed property to A/P.
4. Assists with researching unmatched accounts to determine if payments should be transferred to appropriate invoices, or if payments should be returned to the original sender.
5. Resolving Credit Balances from Department inquiries and takes actions to transfer.
6. Analyzes payer reimbursement against payments received from insurance payers to ensure adherence to contract fee schedules.
7. Understanding of IDX Pricing Module and appropriately identifying underpayments.
8. Utilizes IDX and Contract Manager reports to monitor and evaluate billing and collection issues, providing detailed data and recommendations to management.
9. Develops expertise with payer specialty-specific payment policies, by using the payer assigned websites.
10. Interact with managed care payers regarding claim payment issues, rejections and incorrect/reduced payments.
11. Assists with preparing payer fee schedules for uploading into IDX.
12. Assists with preparing reimbursement modeling for potential affiliate groups, managed care contracts or to evaluate new services or programs.
13. Assists with creating pricing for new procedure codes, creating dummy codes for various specialty departments and is able to communicate the information to IT to update IDX
14. Identify research and provide statistical analysis regarding rejections and other billing, coding and reimbursement issues impacting revenue in clinical areas.
15. Serves as a back up to the Senior Healthcare Analyst to assist with creating User ID?s/Passwords for MFA employees to use the various insurance websites
16. Ability to work collaboratively and build positive business relationships with clinical areas and the payer community.
17. Reconciliation of deposits from various sources to cashier report.
18. Perform other work duties as required
Experience:
Five years experience in health care /managed care environment, preferably in a large physician practice or a combination of experience and education. Knowledgeable in physician reimbursement and managed care claim payment issues. Excellent communication skills and ability to effectively communicate with various levels of management in a multi-disciplinary environment. Strong analytical skills with attention to detail. Advanced level with Excel and financial analysis related to physician reimbursement
Job Type: Full-time
Required experience:
Healthcare Payor/Credit Balance: 4 years
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